Directory information, not recipient confirmation. Fax numbers can change and differ by department, location, form, or plan. Confirm this destination directly with ConnectiveRx before sending sensitive documents. FaxFlow is not affiliated with this organization.
ConnectiveRx fax number
(908) 809-6249
Copay savings program administration
Used for: Copay savings program reimbursement submissions (XIAFLEX Copay Savings Program) and related patient communications
Fax destination details
- Department
- Copay savings program administration
- Purpose
- Copay savings program reimbursement submissions (XIAFLEX Copay Savings Program) and related patient communications
- Form
- Copay Reimbursement Form — XIAFLEX Copay Savings Program Reimbursement Form
- Address
- 1 Crossroads Dr, Bedminster, NJ 07921
- Voice phone
- (908) 809-6100
- Website
- Visit organization website
Before you send
- Confirm that this exact department handles your document or request.
- Check the organization website or call its main line for the current fax number.
- Include a cover sheet and any case, member, claim, or form reference required.
- Keep the delivery confirmation with your submission records.
Complete the form with patient and prescription information, attach required documentation (e.g., Explanation of Benefits or receipts), and submit via fax to this number (1-908-809-6249). You may also submit by mail or email per the program's instructions.
Official form instructions are published as a downloadable file on the organization's website.
Sources and verification
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